Central and local government see digital as an opportunity to improve public services. From the management of diabetes through online reporting of daily blood sugar measurements to clinically supported social networks for anxiety and depression, digital technologies are changing the way we deliver health care.

While online services are increasingly accessible, numbers of people that have the confidence and trust needed to access an online service are still not what they could be. In Britain, 12.6million adults lack these basic digital skills - that’s 23% of our adult population. There’s a risk that by making services digital we leave some of those who need these services most, behind.

The online sexual health service - SH:24 was developed to help make access to sexual health services easier. With insufficient capacity to meet demand in clinics online services can help.

Most users of local sexual health services are young - three quarters are aged under 35 years and this group are more likely to have used digital services before (nationally 99% of those under 35 have used the internet in the last 3 months). But there is a big difference between ‘ever having used the internet’ and having the access and skills to navigate an online testing service

So, we are working to make access easier.

The online interface needs to be as clean and simple as possible; language should be accessible and instructions clear. An iterative approach to service development - testing the interface at each stage of development helps with this.

If we build skills to use online services among clinic users we can also increase access. The most important predictor of online sexual health service use is whether someone has used an online service before. So helping people to use it the first time is important. Having tablets in clinic so that people can get support with their first time use makes it more likely that people will use the service on their own in the future.

By making connections with services that work with vulnerable people we have been able to deliver STI tests to sex workers and homeless people, people who might not access clinic services. We applied a little creativity to our usual service pathway and were able to support these groups to be able to use the service. We have also been working with young people to understand when they would like an online service and when they would prefer to talk to someone face-to face.

However, we can’t stop there.

Cuts are putting more pressure on physical services and inevitably, this will drive more people online. We need to be mindful of issues that vulnerable people might experience beyond their sexual health and ensure we’re taking every opportunity to direct them to the right support where we can.

Our director lead for Reproductive Health, Safeguarding and Evaluation, Dr Paula Baraitser will be speaking at the FSRH Conference in November on this very subject and we want to start the conversation early by hosting a Twitter conversation entitled Online sexual health services: are they the answer? Are we excluding vulnerable groups?

We’re hoping to hear from sexual health practitioners as well as wider health and social care workers about their experiences of supporting people in both physical and digital health services. Some things we’d like to think about:

What are the benefits and limitations of online (sexual) health services?

Who are we talking about when we talk about vulnerable people?

How do we ensure safe inclusion for vulnerable people in service delivery?

What strategies have you used or could others use to support access to online services?

Join the conversation on twitter on Tuesday 24 October, 7pm GMT. We’ll post the questions before the chat on this blog on Monday 23 October to give you a bit of time to think about what you might want to say - enter your name and email below to get alerted to when the questions are online: